HomeMy WebLinkAbout308388 02/22/17 -4y',C9q�P CITY OF CARMEL, INDIANA VENDOR: 355031
ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH%k!RQK AMOUNT: $*******188.00*
is CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 308388
9M)•_._i` CHICAGO IL 60677-7001 CHECK DATE: 02/22/17
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DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4340700 480425 188.00 MEDICAL FEES
Voucher No. Warrant No.
355031 Community Occupational Health Services Allowed 20
7169 Solution Center
Chicago, IL 60677-7001
In Sum of$
$ 188.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO#or INVOICE NO. ACCT#/TITL AMOUNT Board Members
Dept#
1081-99 480425 4340700 $ 188.00 1 hereby certify that the attached invoice(s), or
bill(s) is(are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
February 14, 2017
Signature
$ 188.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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Bill to: Lynn Russell For: Carmel Clay Parks &Recreation
Carmel Clay Parks &Recreation 01/17
1411 E. 116th St.
Cannel, IN 46032-
Proc Code Date Description Qty Charge Receipt Adiust Balance
746404 01/18/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Stephen E Abshire Balance Due: 47.00
746404 01/18/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Ashleigh M Baker Balance Due: 47.00
746404 01/31/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Thomas L Brown Balance Due: 47.00
746404 01/31/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Rebecca E Lamson Balance Due: 47.00
3nuoice,#-480425
Please remit payment promptly
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